| Doctor Name: | DR. PAM L JOHNSON |
| NPI Number: | 1184764235 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | M5254 |
| Business Practice Address: | 1905 Dove Crossing Ln #c Navasota, TX - 778685272 |
| Business Phone Number: | 9368250000 |
| Business Fax Number: | 9368258001 |
| Mailing Address: | 1500 University Dr E, Suite 100 COLLEGE STATION |
| State: | TX |
| Postal Code: | 778402600 |
| Phone Number: | 9368461100 |
| Fax Number: | 9792609390 |
| NPI Enumeration Date: | 02/07/2007 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | M5254 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |